What is it about 3 a.m.? Suddenly you’re awake, your heart is pounding. You’re sweating. You feel a whoosh of panic. Your mind is racing. You realize you were dreaming about a treatment plan for your former neighbor Mrs. Jennings. How long has it been since she was in with her three kids? And what about Mr. Jennings?

Unfortunately, the wheels keep turning. You wonder, has Mr. Dodd scheduled that crown appointment? He said he would. He seemed like he understood why it was necessary. And what about Jenny the bride? She was really interested in whitening. What has she decided? One case and then another and another flips through your mind like a slideshow, and by 5 a.m. you’re wondering just what exactly is happening to case acceptance. How many patients are agreeing to treatment in the chair and then never following through? More than you think. And while many factors influence this, here are the top six.

1. You’re not using the technology tools available. It may not be convenient. You and your team may not have completed necessary training. You may be used to diagnosing and explaining procedures without them. Regardless of the reason, technology tools are a tremendous resource in helping patients to thoroughly understand the condition of their oral health and the importance of proceeding on your recommendations.

2. You fear the word “NO.” No one likes rejection. But few doctors consider the fact that the patient isn’t saying “no” they are saying “not now.” The patient isn’t ready to proceed for any number of reasons. However, that does not mean you and your team stop educating patients on their oral health conditions as well as the consequences of delaying necessary treatment.

3. You’re too busy to do a comprehensive hygiene exam. This requires a good look at your vision, goals, and scheduling systems. “Too busy” is often a sign of system inefficiencies.

4. There are no clear payment options. Studies show that patients avoid dental treatment due to cost more than pain. Yet if they feel that the costs measure up to the service received there is no complaint. Many patients will not question fees if the practice has demonstrated that they can deliver superior service. From the first phone call to dismissal, consistently demonstrate the “value” for services that the patient is receiving. Offer flexible payment options such as CareCredit.

5. There’s no defined follow-up system in place. Each day, the hygienist should select at least two or three patient records in the hygiene schedule for the upcoming week. Look for patients with outstanding incomplete dentistry diagnosed at the last visit, patients who have not completed procedures that had been started, and reactivated patients who need re-exams.

6. You and your team lack communication skills. Pay attention. Listen to what the patients want and why they are coming into the practice. Addressing the smaller issues and offering more conservative restoration options, provided that’s what is in the patient’s best interest, can be absolutely critical before recommending larger more extensive alternatives.

When presenting and discussing treatment options make it clear that you care. To paraphrase leadership guru John Maxwell, “Patients don’t care how much you know until they know how much you care.” Remind yourself and your team of that fact regularly. Next, get excited and get others excited. If you are talking to Mrs. Jones about her anterior crowns and exhibiting all of the enthusiasm of a chimney brick, don’t expect her to go gaga over what you are offering. Just as success breeds success, excitement in you will generate excitement in your patients.

Show enthusiasm, but keep it real. Talk about what makes sense for the patient now and over the long term, and together agree on what action will be taken and the next steps to get the process started. Remember that you do not practice in an ideal world where every case presentation is immediately accepted, scheduled, completed and paid for. Every dentist faces real world challenges that include procrastinating patients, fearful patients, unmotivated patients, financially concerned patients, spineless patients who allow others’ ill-informed comments and opinions to influence them, and insurance-only patients.

Expect delays, questions, hesitations, concerns, worry, and everything in between. And respond with patience, additional answers and clarifications. Be sincere and understanding. In most cases, when the patient is ready, feels well informed, and is prepared to make the necessary investment, they will proceed. And you both will be all the richer.

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